Ovarian cancer is the leading cause of gynecologic cancer death for women in the United States. At least 70% of women still present with advanced disease and most will die from ovarian cancer within 10 years. Importantly, the cure rate for early disease is quite high, suggesting that better biomarkers with high specificity and sensitivity could significantly reduce the mortality associated with this disease. Inhibin and MIS are emerging biomarkers for ovarian cancer. CA-125 is currently used for a subset of ovarian cancers. Our hypothesis is that assays that provide greater sensitivity and multiplexing capabilities may allow earlier diagnosis and detection of recurrent disease. It is predicted that earlier diagnosis of nascent or drugresistant disease will permit aggressive treatment at earlier stages of ovarian cancer, resulting in improved survival. Advances in nanotechnology, specifically the development of a nanoparticle-based bio-bar code assay, now allow the identification and study of protein markers at concentrations that are many orders of magnitude lower than what can be detected with conventional diagnostic tools for proteins. A goal of the proposed research is to evaluate whether nanoassays that detect ovarian cancer markers, in particular inhibin, Mullerian inhibiting substance (MIS;anti-Mullerian hormone, AMH), and CA125, in serum or urine samples, can be used to detect early stage ovarian cancer in settings where conventional technology does not possess the requisite sensitivity. Ultimately, the combination of several biomarkers into a single nanoscale gynecologic oncology screening tool is expected to identify patients in early stages of ovarian cancer or cancer recurrence, when treatments are most effective, and reduce the significant mortality associated with this disease. To accomplish our goals, we have assembled a highly interdisciplinary team with strong backgrounds in cancer research, clinical diagnostics, sample processing, microfluidics, and nanotechnology.